Provider Demographics
NPI:1972860310
Name:SOUTHCROSS FAMILY MEDICINE PLLC
Entity Type:Organization
Organization Name:SOUTHCROSS FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:I
Authorized Official - Last Name:KALDAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-900-5163
Mailing Address - Street 1:1341 E MOREHEAD STREET
Mailing Address - Street 2:101
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204
Mailing Address - Country:US
Mailing Address - Phone:704-900-5163
Mailing Address - Fax:704-900-5263
Practice Address - Street 1:1341 E MOREHEAD STREET
Practice Address - Street 2:101
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204
Practice Address - Country:US
Practice Address - Phone:704-900-5163
Practice Address - Fax:704-900-5263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty